Table 2.

Global challenges and potential solutions for enhancing organ donation

Challenges	Description	Potential solutions
Organ shortage	Demand for organs, especially kidneys, far exceeds supply globally	Expand donor pools via opt-out systems (e.g., Singapore, UK), paired kidney exchanges, and use of marginal donors
Family consent barriers	Family refusal is a major cause of non-utilization, with legal rights to overrule deceased’s wishes in most regions (except USA)	Enhance public education to address misconceptions and may involve cultural/religious leaders
Consent system variability	Opt-in systems yield lower donation rates	Adopt opt-out systems where culturally appropriate, standardize consent protocols, and improve transparency in organ allocation
Cultural and ethical concerns	Religious beliefs, fear of body mutilation, and mistrust in healthcare systems deter donation	Develop culturally sensitive education programs, engage religious authorities, and ensure ethical practices to build trust
Organ trafficking	Illegal trade exploits vulnerable populations, driven by organ shortages in high-income countries	Strengthen global regulations (e.g., declaration of Istanbul), increase legal donor pools, and monitor transplant tourism
System inefficiencies	Logistical delays, suboptimal matching, and lack of standardized brain death criteria reduce organ availability	Streamline logistics with technologies like ex vivo perfusion, standardize brain death definitions